Excessive sinus pauses and their elimination in a patient with sleep apnea syndrome

A 40-year-old man with severe sleep apnoea syndrome presented significant sinus pauses during a 48 h electrocardiogram Holter recording. Holter analysis showed one sinus pause of 6.4 s duration, and many pauses greater than 3 s. The 48 h Holter reevaluation, after a continuous positive air pressure device was applied, showed no pauses. The electrophysiological study was negative for sick sinus syndrome.